| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
436 |
128 |
$15K |
| J3490 |
Unclassified drugs |
273 |
13 |
$10K |
| 99215 |
Prolong outpt/office vis |
156 |
96 |
$8K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
101 |
62 |
$1K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
39 |
13 |
$295.56 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
39 |
13 |
$220.81 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
14 |
$134.27 |
| J7050 |
Infusion, normal saline solution, 250 cc |
39 |
13 |
$79.31 |